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Old 02-06-2005, 16:14   #1
That Java Guy
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MSR Miox and an unaproved use

If y'all have seen this already over on another board, sorry for the repeat.

Here is another use of the Miox Pen - this is the article I posted on 2 Dec over on the Lightfighter Board.....


This is not meant to be a replacement for copious amounts of irrigation with clean water. My number 1 choice would be to use about 5 liters of sterile water to flush that wound.

If I did not have sterile water than I would use 5 liters of water treated with the Miox device

If I did not have 5 liters of water to spare I would treat it the way I did here. I would rinse out the big chunks and dump the Miox solution into the wound - the idea being that the Miox solution would kill all the bugs in the wound. That way if I am in the middle of BFE - I could hopefully prevent a massive infection resulting in a whole lot of tissue loss.

I never intended this to be the #1 treatment - just an option for austere conditions where ways, means and supplies are greatly limited. Please remember that.



Posted originally 2 Dec 2004So - couple days ago I had a pt - guy was out geting qualified on an ATV and wrecked. He tore a pretty good sized hole in hid calf....

Dressed wound courtesy of his buddies
http://img.photobucket.com/albums/v2...cal/the-pt.jpg

Here is what I saw after unwrapping it
http://img.photobucket.com/albums/v2.../leg-wound.jpg
Involvement went pretty deep - through the muscle fascia and about an inch into his calf muscle.

After irrigation with NS to get the big chunks out I poured the solution from my Miox (3 clicks) into the wound - and then closed him up
http://img.photobucket.com/albums/v2...ep-to-pour.jpg
http://img.photobucket.com/albums/v2...al/Pouring.jpg
http://img.photobucket.com/albums/v2...al/closure.jpg

Saw him yesterday and today - no signs of infection. Please note - I did not give him any sort of anti biotics and that was one DIRTY wound.

I won't go anywhere without my Miox - I think it's a pretty important device - water purifier and wound treater.

Have fun!

Dan
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Old 02-06-2005, 16:16   #2
That Java Guy
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again from the Lightfighter Board - couple days post repair


OK - I tracked him down. I believe it is 3 days post surg now. I have been out of the office so I have not been checking knuckhead here - note the lack of bandage on it - patient says "I know you said keep it covered but I thought I ought to leave it open so it can air out. I also told him to keep off of it and elevated for a few days - Mr opposite thought he ought to be walking around just because. Some people you really have to babysit.

OK - note - healing it looks OK. There is some swelling from patient here walking around on it - but it is no hotter than any other part of either leg - no pain - no redness and no fever so I think he will be OK.

Up and walking around on an uncovered wound that communicates deep to the muscle fascia with no profolactic antibiotics - and no infection - I guess the Miox did something right

Dan

Here is the pic...

http://img.photobucket.com/albums/v2...-days-post.jpg




And finally...............


10(ish) days post - moments before suture removal.

http://img.photobucket.com/albums/v2...-days-post.jpg

Never even got near antibiotics - never mind taking any

Not too bad considering the initial injury and super patient's anti compliance with order

Dan
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Old 02-06-2005, 16:17   #3
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Dan:

Saw it there too.

Good skinny, thanks for sharing.

TR
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Old 02-07-2005, 04:28   #4
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Nice stitch job.

re: 10 days past pic
How did you prevent the little holes from appearing where each stitch was.

Did you use betadyne or hibiclens at all before you stitched him up? (I think you implied you did not, but just curious...)

FrontSight
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Old 02-07-2005, 07:18   #5
swatsurgeon
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Java Guy,
the miox did a hell of a job especially with no infection and a closed wound....that's one I wouldn't have closed the skin on due to the risk of infection.....delayed primary closure maybe but not a true primary.....but can't argue with your success with a primary closure, you certainly beat the odds.
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Old 02-07-2005, 12:08   #6
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I admit I was worried about this guy. I talked with my Doc, PA and the patient all about the associated risks of the infection and about how a trial like this may prove valuable to us if and when we treat bad wounds downrange in less than perfect environments. Everyone agreed with close monitoring and large amounts of antibiotics on hand that we should give it ago. Of course at the time I didn't realize that I needed to put a GPS collar on the PT to keep track of him.

There were little holes in the skin In the last picture the wound is a bit on the moist side. After I grabbed him for the 3 day post picture I gave him some OP sites to put over his sutures. The deal was if he would not wear a bandage he would kep the opsite on - being breathable yet waterproof - allowing him to shower and do what he needed to do. I showed him how to put it on so it would not place too much pressure on the sutures. SO, back to the last pic - he had gone to the gym that morning, got sweaty, sweat inside the Opsite also and it was just a little moist - so I think the suture holes didn't show up as well because of that. I should have washed him up and shot a post suture removal picture also. Sorry 'bout that.

Dan
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